When you get a cold, you get a headache; when you stay up late and work overtime, you get a headache; when you are nervous, you get a headache. Headaches are like pins and needles, and headaches are like being under a spell that has become one of the most common symptoms that plague people’s lives.
Most headaches in daily life are not too dangerous, but sudden and severe headaches require immediate medical attention.
Headaches that are accompanied by “red flags” such as sensory disturbances, impaired physical activity, and changes in level of consciousness also require extra vigilance.
Keep a record of the location, duration, severity and nature of the headache, as this information can be helpful to your doctor in making a diagnosis.
Painkillers can relieve headaches, but they are not a cure-all. If the headache is not controlled, you can also see your doctor for a more targeted treatment option.
Why do I get headaches?
Headaches have many different mechanisms and triggers. Pain receptors are located in the intracranial sinuses, meninges, arteries, and cranial nerves, as well as in the extracranial periosteum, subcutaneous tissue, muscles, eyes, ears, sinuses, and other areas, and their activation brings on a variety of headache signals.
Some headaches are secondary to other diseases. For example, colds and flu are often accompanied by headaches. A headache can be caused by a problem inside the skull, such as a brain hemorrhage, intracranial infection or tumor. Outside the skull, there are many factors that cause headaches, such as glaucoma, acute dental pulpitis, sinusitis, etc.
More common headaches have no clear organic disease and are classified as “primary headaches”. For example, tension headache, migraine, etc. The cause of these headaches is not fully understood.
How do I describe a headache to my doctor?
The characteristics of a headache are important for your doctor to know, and you can also note these points when you have a headache.
The location of the headache: does it hurt all over the head, or is it localized, and is the pain fixed or irregular?
How does the pain change over time: does it occur suddenly, or does it get worse slowly? Is the pain constant, or does it come on in spurts? How long does an attack last?
Nature of the headache: Does the pain feel like a cut, a burning, a swelling, or a throbbing pain?
Level of pain: If the most pain is a 10 and no pain is a 0, how would you rate the current headache?
Factors that trigger and relieve headaches: Some common factors may be menstrual flow, climate change, poor sleep, etc.
Symptoms that occur with headaches: Do headaches occur along with fever, vomiting, impaired body movement, sensory disturbances, slurred speech, etc.?
What kind of tests might the doctor recommend? What are they for?
In many cases, the doctor can make a judgment based on the characteristics of the patient’s signs and symptoms, but in some specific cases, ancillary tests are still very important.
CT of the head
Imaging may be recommended to detect or rule out organic pathology. Emergency head CT is the quickest way to determine the presence of intracranial lesions. It can show the presence of abnormal bleeding in the skull and can also initially identify some intracranial tumors.
Magnetic resonance imaging (MRI)
However, CT has its shortcomings. It is not as powerful in identifying diseases such as cerebral infarction and white matter lesions. Therefore, some cases require magnetic resonance imaging (MRI), which is uniquely suited for the diagnosis of intracranial lesions and allows the doctor to visualize structural abnormalities, vascular lesions, and even some biochemical changes in the brain.
Lumbar puncture
In some cases, doctors may recommend a “lumbar puncture” to check the condition of the cerebrospinal fluid. The outer layer of the brain and spinal cord is wrapped in a membrane called the arachnoid membrane, and the clear fluid inside the arachnoid membrane is the cerebrospinal fluid. The brain and spinal cord are normally immersed in this fluid, and the cerebrospinal fluid provides protection and part of the nutritional supply.
When the subarachnoid space is reached by puncturing through the space in the lumbar spine, cerebrospinal fluid flows out along a fine needle. This allows the pressure of the cerebrospinal fluid to be measured to determine if the headache is due to high cerebrospinal fluid pressure. In addition, the analysis of the cerebrospinal fluid can also determine if there is an infection in the skull.
How is it treated?
For headaches caused by organic diseases, the most important thing is to treat the cause. For example, subarachnoid hemorrhage requires surgery as soon as possible, intracranial infection requires anti-infection treatment, glaucoma requires rapid reduction of intraocular pressure, and so on. Once the diagnosis is clear, it is important to actively cooperate with the hospital for treatment.
As for primary headaches, medication can relieve symptoms or help prevent attacks. Many times, common over-the-counter painkillers are effective in relieving daily headaches, and are safe enough to take once in a while.
However, painkillers are not a panacea. If headache attacks are frequent, painkillers alone may not be enough to control them. Relying on painkillers too often to relieve a headache may turn an intermittent migraine into a daily “medication overuse headache”. If you have been using painkillers two or more days a week for three months and the headaches become more frequent, you may have an overuse headache. In this case, you can seek help from your doctor, and your headache symptoms can be relieved after stopping your current pain medication and using preventive treatment.
In addition, lack of sleep, stress, emotional instability, and certain foods such as cheese and cured meats may also trigger migraine attacks, so it is essential to avoid these triggers.